2022 Volume 31 Issue 5 Pages 324-332
Upper lumbar disc herniation generally presents with various symptoms, and microscopic surgery is difficult due to anatomical features. We retrospectively analyzed the clinical symptoms, neurological features, and chronological transition of surgical options in 67 patients who underwent surgical treatment at our center between January 2004 and March 2021. There were 18 upper lumbar disc herniations at L1/2 and 49 at L2/3. Most of the clinical symptoms were back pain and leg pain/numbness, which were distributed in the inguinal and anterior thigh regions, along with foot numbness. There was a tendency for bladder dysfunction in cases with upper lumbar disc herniations, as compared to lower herniations. The deep tendon reflexes were decreased at L2/3 ; however, in some cases, they were increased at L1/2. Microscopic discectomy was rarely performed at L1/2, whereas it was performed in approximately half of the cases at L2/3. In our center, endoscopic surgery was introduced in 2016 and condoliase injection treatment in 2019. Surgical options have changed over the past several years. Less invasive surgeries, such as endoscopic surgery and condoliase injection treatment, seem to be useful surgical options for upper lumbar disc herniation.
